For seventeen years The Betrayal Bond has been the primary source for therapists and patients wrestling the effects of emotional pain and harm caused by exploitation from someone they trusted.

Divorce, litigation, incest and child abuse, domestic violence, kidnapping, professional exploitation and religious abuse are all areas of trauma bonding. These are situations and relationships of incredible intensity or importance lend themselves more easily to an exploitation of trust or power.

In The Betrayal Bond, Dr. Carnes presents an in-depth study of these relationships; why they form, who is most susceptible, and how they become so powerful. Dr. Carnes also gives a clear explanation of the bond that compels people to tolerate the intolerable, and for the first time, maps out the brain connection that makes being with hurtful people comparable to 'a drug of choice.' Most importantly, Carnes provides practical steps to identify compulsive attachment patterns and ultimately to change or end them for good.

This new edition includes:

New science for understanding how our brains can make a prison of bad relationships

New assessments and insights based on 50,000 research participants

A new section utilizing the latest findings in attachment research and narrative therapy to concretely rewrite and rescript bad experiences

A redefinition of the factors contributing to addictive relationships

What Trauma Does to People

After a traumatic experience, the human system of self-preservation seems to go onto permanent alert, as if the danger might return at any moment. —Judith Herman, Trauma and Recovery

A key skill to navigating life's inevitable stressors and challenges is our brains' ability to maintain flexibility and make choices on how to respond when faced with a threat or a challenge. This capacity involves primarily the prefrontal area of the brain and emerges slowly during the course of development.

Those who have experienced trauma may find that they blow up in response to minor provocations, freeze when frustrated, or become helpless in the face of trivial challenges. This inflexibility diminishes the capacity to choose, and without understanding the context of the reactions, their behavior can appear bizarre or out of control.

"Neuroimaging technology has revealed that when people are reminded of a personal trauma they activate the areas of the brain regions that support intense emotions while decreasing activity of brain structures involved in the inhibition of emotions and the translation of experience into communicable language" (van der Kolk, 2006 p. 2). Simply it becomes difficult to choose an appropriate behavioral response in the face of intense emotions. Due to the reality that most traumas occur within the context of interpersonal relationships the problem becomes even more complex. One significant factor in the development of the prefrontal areas of the brain and the ability to respond to emotions effectively occurs as a child is able to develop in the presence of familiar and trusted people in his or her life. These significant relationships are critical to development and later to the ability to emotionally regulate. The child being in distress signals caregivers to respond with an appropriate action. They discover what is troubling the child and how to respond in a way to comfort and help the child to soothe the emotional reactions. This process becomes thwarted when the caregiver is unable to respond to the emotional needs of the child and developmentally the child does not learn the process of self-soothing.

Bessel van der Kolk, MD, is a clinician, researcher and teacher in the area of posttraumatic stress. His work integrates developmental, neurobiological, psychodynamic and interpersonal aspects of the impact of trauma and its treatment. He is a professor of psychiatry at Boston University Medical School and serves as the director of the National Center for Child Traumatic Stress Complex Trauma Network. He states, "Most traumas occur in the context of interpersonal relationships, which involve boundary violations, loss of autonomous action, and loss of self-regulation. When people lack sources of support and sustenance, such as is common with abused children, women trapped in domestic violence, and incarcerated men, they are likely to learn to respond to abuse and threat with mechanistic compliance or resigned submission" (van der Kolk 2006, p. 7).

Interpersonal relational trauma occurs where there is exploitive harm done to one person by another within the context of a personal relationship. This can occur in the context of many human relationships such as marriage, family, parent/child, work, or dating in the form of betrayal, addiction, abuse, violence, or exploitation. There is significant impact on the victim and often results in post-traumatic stress disorder (PTSD).

Trauma can restrict the ability to resolve future stressful and painful situations. Simply put, it undermines resilience. One long-term impact of trauma is the fact that often-traumatized individuals have difficulty recognizing how they are feeling and then fail to respond in an appropriate and helpful way. They become out of touch with their own feelings, bodies, and needs, which in turn makes it more difficult to respond to the feelings, sensations, and needs of others in their lives.

The pathway of healing includes learning to reconnect to our feelings, bodies, and the others in our lives. We learn to be present again with ourselves and the world around us. Being present and paying attention changes our lives. Most cultures and religions have practices that help us in this pursuit. The goal often has been to enrich our personal awareness and knowledge of self. Dr. Daniel Siegel is a clinical professor of psychiatry at the UCLA School of Medicine, where he is on the faculty of the Center for Culture, Brain, and Development and the founding co-director of the Mindful Awareness Research Center. Siegel emphasizes how being fully aware individually helps us to attune to another person, not only changing us but changing the very nature of our personal relationships. Simply put, "attuned relationships promote resilience and longevity" (Siegel 2010a, p. 13). This attunement helps with neural integration, which allows us to be more flexible and resilient as we deal with the curveballs of life. Siegel discusses how our resilience can be undermined by past trauma, addiction, and loss when we begin to respond to life's challenges in a restricted manner. He states in his book Mindsight that "when we block our awareness of feelings, they continue to affect us anyway. Research has shown repeatedly that even without conscious awareness, neural input from the internal world of body and emotion in?uences our reasoning and our decision making. Even facial expressions we're not aware of, even changes in heart rhythm we may not notice, directly affect how we feel and so how we perceive the world. In other words, you can run but you cannot hide" (Siegel 2010, p. 124). This book highlights how attachment can become toxic; these are the underpinnings of trauma bonds. Our bonding in attachment can be undermined by trauma, either in the past or in our present.

What Is Trauma?

Throughout our life spans, we are all introduced to trauma in one way or another. Dr. Bessel van der Kolk states, "As human beings we belong to an extremely resilient species. Since time immemorial we have rebounded from our relentless wars, countless disasters (both natural and man-made), and the violence and betrayal in our own lives. But traumatic experiences do leave traces, whether on a large scale (on our histories and cultures) or close to home, on our families, with dark secrets being imperceptibly passed down through generations. They also leave traces on our minds and emotions, on our capacity for joy and intimacy, and even on our biology and immune systems" (van der Kolk 2014, p. 1). Unresolved trauma undermines our resilience and our capacity to connect both to ourselves and to those around us.

At its core, the human response to trauma is about the loss of connection, the loss of connection to our identity, our bodies, our memories, and to the people surrounding us in our lives. The loss of connection can be hard to recognize at times, but the result is recognizable. Trauma has the capacity to undermine our sense of self, feelings of well-being, and connection to life. The world within and around us can become very restrictive, limiting our ability for choice, creativity, and connection.

Dr. Peter Levine, a clinical consultant at The Meadows, developed Somatic Experiencing, a naturalistic approach to the resolution and healing of trauma, defines trauma as "any experience which stuns us like a bolt out of the blue; it overwhelms us, leaving us altered and disconnected from our bodies" (Levine and Klein, 2006, p. 4). When individuals are in the overwhelmed state, their previously held coping mechanisms no longer function, and they can be left feeling hopeless and helpless. The impact of trauma is psychological, neurobiological, and psychobiological. In other words, it affects our mind, body, spirit, and relationships.

This loss of connection to ourselves affects us in many different ways. One of the most pronounced is in our ability to emotionally regulate and in our perception of ourselves and those around us. Often the result is emotional reactions that are under- or overregulated. Dr. Daniel Siegel refers to this process as the window of tolerance in which arousal fluctuates between high arousal and low arousal. In the middle is the optimal arousal zone. Those who have suffered through traumatic situations often have a narrow band of optimal arousal and fluctuate between high and low arousal. At times they may overreact to something relatively minor and underreact when action is preferred. One of the goals in the healing process is to widen this "window of tolerance" and increase the optimum zone. Working in therapy, attending recovery groups, talking with trusted friends, mindfulness, connection to our bodies, and attention to self-care are all ways of increasing our internal integration and promoting connection. In this process the window of tolerance is widened, which allows us to regulate in the presence of stress or intense emotions in a way that we would not have been able to do prior. (Siegel 2010b).

Interpersonal Relational Trauma

This book focuses on the impact of interpersonal relational trauma. We will be exploring the impact of betrayal and exactly what traces are left behind. There are unique qualities when the trauma is by the hand of those who are expected to love, protect, and cherish us. This type of trauma is interpersonal relational trauma. When we are hurt, it is natural to turn to those we are closest to for comfort and healing. However, when these people are also the source of our trauma and pain we are lost in a painfully difficult double bind. It is confusing and difficult to navigate. Before delving into relational trauma, it is important to understand the nature of trauma and its impact. Since the original publication of this manuscript, our understanding of trauma has expanded through the work of neuroscience.

Patrick J. Carnes, Ph.D., is an internationally known authority on addiction and recovery issues. He has authored more than twenty books including the bestselling titles Out of the Shadows: Understanding Addiction Recovery, Don't Call It Love, and A Gentle Path Through the Twelve Steps. Dr. Carnes' research provides the architecture for the 'task model' of treating addictions that is used by thousands of therapists worldwide and many well-known treatment centers, residential facilities, and hospitals. He is the executive director of the Gentle Path Program, which specializes in dedicated treatment for sexual addiction. Visit Dr. Carnes at www.patrickcarnes.com.